Synopsis: Parent-Child Interaction Therapy (PCIT) was designed for children presenting with extreme behavioral problems including oppositional and conduct disorders. Integrated within a system of care, this evidence-based program resulted in outcomes congruent with research conducted within University contexts. Fidelity measures indicate that community mental health providers were able to implement PCIT as intended. Parents reported reductions in behavioral problems, and reported less parental stress. Clinician measures document improvements in PCIT promoted behaviors that reinforce prosocial behaviors and remove reinforcements for negative behaviors.